Current Treatment Patterns of Aplastic Anemia in China: A Prospective Cohort Registry Study.

Aplastic anemia (AA) is a hematologic disease characterized by pancytopenia and hypocellular bone marrow, potentially leading to chronic anemia, hemorrhage, and infection. The China Aplastic Anemia Committee and British Committee for Standards in Haematology guidelines recommend hematopoietic stem-cell transplantation (HSCT) or immunosuppressive therapy (IST) comprising antithymocyte globulin (ATG) with cyclosporine (CsA) as initial treatment for AA patients. With limited epidemiological data on the clinical management of AA in Asia, a prospective cohort registry study involving 22 AA treatment centers in China was conducted to describe the disease characteristics of newly diagnosed AA patients and investigate real-world treatment patterns and patient outcomes. Of 340 AA patients, 72.9, 12.6, and 3.5% were receiving IST, traditional Chinese medicine, and HSCT, respectively, at baseline; only 22.2% of IST-treated patients received guideline-recommended ATG with CsA initially. Almost all patients received supportive care (95.6%) as blood transfusion (97.8%), antibiotics (63.7%), and/or hematopoietic growth factors (58.2%). Overall, 64.8% achieved a partial or complete response, and 0.9% experienced relapse. No new safety concerns were identified; serious adverse events were largely unrelated to the treatment regimen. These results demonstrate the need to identify and minimize treatment barriers to standardize and align AA management in China with treatment guideline recommendations and further improve patient outcomes.

Effect of Dendrobium officinale on D-galactose-induced aging mice.

OBJECTIVE: To examine the effect of Dendrobium officinale (DO) on D-galactose-induced aging mice. METHODS: Aging mice was induced by D-galactose at 0.125 g/kg for 10 weeks through subcutaneous injection except for the negative control group. After 10 days, according to complete random design, the aging modeling mice were randomized into 4 groups: aging control group (10 ML·kg-1·d-1) of distilled water), positive control group (vitamin B6 and ganodema lucidum tablets with a dose of 1 tablet/kg), DO-1 treatment group (DO juice with a dose of 1 g/kg), DO-2 treatment group (DO Polysaccharide with a dose of 0.32 g/kg), 14 mice in each group. All the animals were orally medicated daily for 9 weeks. Cognitive function assessment was performed using the maze test and step-down test. At the end of experiment, the superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and total antioxidant capacity (T-AOC) levels in the serum, the SOD, GSH-Px and nitric oxide (NO) levels in the cerebrum, the SOD and catalase (CAT) levels in the liver, the SOD and NO levels in the heart, and the SOD level in the kidney, were determined using commercial kits. The spleen, liver, heart, cerebrum and kidney were excised for histological study. RESULTS: Compared to aging control group, DO shortened the time of passing through the maze and prolong the step-down latency of aging mice (P <0.05 or P<0.01). DO markedly up-regulated serum levels of SOD, GSH-Px and T-AOC, and restored SOD levels in the heart, liver, kidney and cerebrum to normal status (P<0.05 or P<0.01). DO at the dose of 1 g/kg also signififi cantly improved the degree of spleen lesions (P<0.01). CONCLUSIONS: DO had marked anti-aging effect on D-galactose-induced model of aging. The underlying mechanism could be related to modulation on antioxidation system and immune system. The results indicated that DO could potentially be used as natural drugs or functional foods for preventing aging.

The hypoglycemic activity of Lithocarpus polystachyus Rehd. leaves in the experimental hyperglycemic rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Leaves of Lithocarpus polystachyus Rehd. are used for the treatment of disorders such as diabetes, hypertension, and epilepsy in folk medicine of South China. The possible antidiabetic effects of the leaves were investigated in experimental type 2 and type 1 diabetic rats. MATERIALS AND METHODS: Type 2 diabetic rats received orally three different extracts of Lithocarpus polystachyus Rehd. leaves for 4 weeks (aqueous extract [ST-1], ethanol extract [ST-2], flavonoid-rich fraction [ST-3]). At the end of the experiment biochemical parameters were tested and livers and pancreases were excised for histological study. After the comparison of the pharmacological test results of the three extracts, the one which showed the best bioactivity was further studied to confirm its antidiabetes effect on both type 2 and type 1 diabetic rats. RESULTS: Compared to ST-1 and ST-2, ST-3 had better effects on regulation of blood glucose, glycosylated serum protein, cholesterol, triglyceride, malondialdehyde, superoxide dismutase and attenuation of liver injury in type 2 diabetic rats (p<0.01 or p<0.05). ST-3 administration for four weeks also significantly reduced the fasting serum insulin and C-peptide level and improved the insulin tolerance (p<0.05). In type 1 diabetic rats, ST-3 supplement for three weeks caused significant reduction in fasting blood glucose, total cholesterol, triglyceride, urea nitrogen, creatinine and liver mass, along with significantly inhibiting the decline of insulin level compared to diabetic control (p<0.05 or p<0.01). CONCLUSION: The flavonoid-rich fraction of Lithocarpus polystachyus Rehd. leaves (ST-3) had better beneficial effect than that of the ethanol or aqueous extract in experimental diabetic rats, which means that the bioactivity of the herbal leaves is probably due to the presence of flavonoids. The results also strongly suggest that the antidiabetic effect of ST-3 was possibly through multiple mechanisms of action including blood lipid and antioxidant mediation. The results indicated that the aqueous flavonoid-rich fraction of Lithocarpus polystachyus Rehd. leaves possessed significant protective activity in type 2 and type 1 diabetes.